NOTICE OF PRIVACY PRACTICES

Under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), Carehart, a retail pharmacy is required to provide you with a Notice of Privacy Practices that describes how we may use your information for treatment, payment and other purposes that details your rights regarding the privacy of your health and medical information.

Effective Date: November 28, 2019

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.

PLEASE REVIEW IT CAREFULLY.

OUR OBLIGATIONS:

We are required by law to:

● Maintain the privacy of protected health information

● Give you this notice of our legal duties and privacy practices regarding health information about you

● Follow the terms of our notice that is currently in effect

HOW CAREHART MAY USE AND DISCLOSE HEALTH INFORMATION:

The following is an accounting of the ways that the pharmacy is permitted, by law, to use and disclose your Protected Health Information or PHI.

Treatment: We may use the PHI that we receive from you to fill your prescription and coordinate or manage your health care.

Payment: Pharmacy will disclose your PHI to obtain payment or reimbursement from insurers for your health care services.

Health Care Operations: Pharmacy may use the minimum necessary amount of your PHI to conduct quality assessments, improvement activities, and evaluate the pharmacy workforce. As required by law: Pharmacy is required to use or disclose PHI about you as required and as limited by law.

Public Health Activities: Carehart may use or disclose PHI about you to a public health authority that is authorized by law to collect for the purpose of preventing or controlling disease, injury, or disability. This includes the FDA so that it may monitor any adverse effects of drugs, foods, nutritional supplements and other products as required by law.

Health Oversight Activities: Pharmacy may use or disclose PHI about you to a health oversight agency for oversight activities which may include audits, investigations, inspections as necessary for licensure, compliance with civil laws, or other activities the health oversight agency is authorized by law to conduct.

Individuals Involved in your Care: Carehart may disclose PHI about you to individuals involved in your care.

Judicial and Administrative Proceedings: Carehart may disclose PHI about you in the course of any judicial or administrative proceedings, provided that proper documentation is presented to the pharmacy.

Law Enforcement Purposes: Carehart may disclose PHI about you to law enforcement officials for authorized purposes as required by law or in response to a court order or subpoena. About the Deceased: Pharmacy may disclose PHI about a deceased, or prior to, and in reasonable anticipation of an individual’s death, to coroners, medical examiners, and funeral directors.

Cadaveric organ, eye or tissue donation purposes: Carehart may use and disclose PHI for the purpose of procurement, banking, or transplantation of cadaveric organs, eyes, or tissues for donation purposes.

Research Purposes: Carehart may use and disclose PHI about you for research purposes with a valid waiver of authorization approved by an institutional review board or a privacy board. Otherwise, the pharmacy will request a signed authorization by the individual for all other research purposes.

To avert a serious threat to health or safety: Pharmacy may use or disclose PHI about you, if it believed in good faith, and is consistent with any applicable law and standards of ethical conduct, to avert a serious threat to health or safety.

Specialized Government Functions: Pharmacy may use or disclose PHI about you for specialized government functions including; military and veteran’s activities, national security and intelligence, protective services, department of state functions, and correctional institutions and law enforcement custodial situations.

Workers’ Compensation: Pharmacy may disclose PHI about you as authorized by and to the extent necessary to comply with workers’ compensation laws or programs established by law. Disaster Relief Purposes: Pharmacy may disclose PHI about you as authorized by law to a public or private entity to assist in disaster relief efforts and for family and personal representative notification.

Business Associates: Carehart may disclose PHI about you to the pharmacy’s business associates for services that they may provide to or for the pharmacy to assist the pharmacy to provide quality health care. To ensure the privacy of your PHI, we require all business associates to apply appropriate safeguards to any PHI they receive or create.

OTHER USES AND DISCLOSURES:

Carehart may contact you for the following purposes:

Information about treatment alternatives: Pharmacy may contact you to notify you of alternative treatments and/or products.

Health related benefits or services: Pharmacy may use your PHI to notify you of benefits and services the pharmacy provides.

YOUR HEALTH INFORMATION RIGHTS:

The following are a list of your rights in respect to your PHI. Please contact the pharmacist for more information about the below.

You have the right to request additional restrictions of the pharmacy’s uses and disclosures of your PHI; however, pharmacy is not required to accommodate a request. This includes the right to restrict disclosures to Insurances for those products and services you pay out-of-pocket for. You have the right to request that the pharmacy communicate confidentially with you using an address or phone number other than your residence. However, state and federal laws require the pharmacy to have an accurate address and home phone number in case of emergencies. Carehart will consider all reasonable requests.

You have the right to request access and/or obtain a copy of your PHI that is contained in the pharmacy for the duration the pharmacy maintains PHI about you. There may be a reasonable cost-based charge for providing these documents. You will be notified in advance of incurring such charges, if any.

You have the right to request an amendment of the PHI the pharmacy maintains about you, if you feel that the PHI the pharmacy has maintained about you is incorrect or otherwise incomplete. Under certain circumstances we may deny your request for amendment. If we do deny the request, you will have the right to have the denial reviewed by someone we designate who was not involved in the initial review. You may also ask the Secretary, United States Department of Health and Human Services ("HHS"), or their appropriate designee, to review such a denial.

You have the right to receive an accounting of certain disclosures of your PHI made by the pharmacy.

Right to a Paper Copy of This Notice. You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice. Where to Obtain Forms for Submitting Written Requests. You may obtain forms for submitting written requests by contacting the Pharmacy Privacy Officer at Carehart 41 7th Avenue South New York, NY 10014 or by telephone at (212) 321-1010. You will be notified of any breaches that have compromised the privacy of your PHI.

CHANGES TO THIS NOTICE:

Carehart reserves the right to change and/or revise this Notice and make the new revised version applicable to all PHI received prior to its effective date. Carehart will also post the revised version of the Notice in the pharmacy.

COMPLAINTS:

If you believe your privacy rights have been violated, you may file a complaint with our office or with the Secretary of the Department of Health and Human Services. To file a complaint with our office, contact Carehart 41 7th Avenue South New York, NY 10014 or by telephone at (212) 321-1010. All complaints must be made in writing. You will not be penalized for filing a complaint.